Actions of "not None" ,termed as notorious actions,have imposed side effects on society. From the levels of medical management and department directors, the essay analyzed the manifestation, effects and cauls of the actions of "not None". Some suggestions were given to control these actions.

No abstract available.
Anus, Imperforate*

To deterrnine the applicability of the Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system in ICU, 552 ICU patients who had been admitted from March 1, 1992 to February 28, 1993 were analysed. The mean APACHE II score of nonsurvivors was significantly higher than that of survivors (p<0.01) and there was significant relationship between mortality rate and APACHE II score [Mortality rate(%) =2.994XAPACHE II score-14.987 (r=0.97, p<0.001)). However, the majority of postoperative patients had scores less than 20 points and the postoperative patients were more unevenly distributed. These results suggest that the APACHE II score may be useful for analyses of ICU patients but its application in postoperative patients must take into consideration the patient's clinical condition.
APACHE* ; Humans ; Intensive Care Units* ; Critical Care* ; Mortality ; Survivors

A total of 601 anesthesias given to the patients over age 60 who were admitted to Han Gang Sung Shim Hospital during the period from Jan. 1976 to Dec. 1980, were subjected to this clinical review. 1) Of the total 15,609 cases, 601 cases(3.8%) were over 60 years of age consisting of 315 male(52.4%) and 286 female(47.6%). 2) Among the 601 geriatric patients, 453 cases were 60~69 years of age(75.4%), 128 cases were 70~79 years of age(21.3%) and 20 cases were over 80 years of age(3.3%). 3) In the surgical group, 358 cases(59.7%) were general surgery, 120 cases(20.0%) were orthopedic surgery, 34 cases(5.6%) were urology, 20 cases(3.3%) were gynecology respectively. 4) The techniques of anesthesia were 545 cases(90.7%) of general anesthesia, 22 cases(3.7%) of spinal anesthesia and 17 cases(2.8%) of axillary block. 5) Anesthetics were diethly-ether 24 cases(36.3%) and halothane 22 cases(33.3%) in 1976. But there were 5 diethly-ether cases(0.3%) and 120 halothane cases(91.6%) in 1980. 6) For the duration of anesthesia, 81 cases(13%) were within 1 hour, 238 cases(39.6%) within 2 hours, 156 cases(26.0%) within 3 hours and 21 cases over 5 hours. 7) In the classification of physical status of the geriatric patients, 42 cases(7.0%) were class l, 201 cases(33.2%) were class ll, 109 cases (18.1%) were class lll and 8 cases(1.3%) were class lV. 8) Emergency cases were 223 cases(37.1%) and 378 cases(62.9%) were elective. 9) The findings of preoperative chest X-rays revealed that 227 cases(48.8%) were within normal limits, 56 cases(12.0%) had hypertensive heart disease, 24 cases(5.1%) had senile fibrosis, 22 cases(5.1%) had unstabilized tuberculosis and 14 cases(3%) had pneumonis. 10) In the preoperative R.K.G., which covered 50% of the patients, 115 cases(38.3%) were within normal limit, 41 cases(13.6%) showed L.V.H., 30 cases(10.0%) had sinus bradycardia, 13 cases (4.3%) had myocardial lschemia and 7 cases(2.3%) had R.B.B.B. 11) Post-operative mortality rate was 5.8% in 1976, 4.0% in 1977, 3.6% in 1978 and 2.1% in 1980, and over all mortality rate was 3.1%.
Anesthesia* ; Anesthesia, General ; Anesthesia, Spinal ; Anesthetics ; Bradycardia ; Classification ; Emergencies ; Fibrosis ; Gynecology ; Halothane ; Heart Diseases ; Humans ; Mortality ; Orthopedics ; Thorax ; Tuberculosis ; Urology

No abstract available.
Biometry* ; Rheology* ; Umbilical Arteries*

The gene encoding E7 oncoprotein of human papillomavirus type 16 was cloned and expressed in Escherichia coli, and the monoclonal antibodies (Mabs) against this expressed protein were generated. For the efficient immunization, two kind of recombinant E7 protein in fusion form were produced. One was maltose binding protein (MBP) fusion type (MBP-E7) and the other was T7 phage gene 10 product fusioa type (gene 10-E7). Immunization with these two fusion protein to mice, finally two Mabs (VD6 and IB10) were obtained. VD6 and IB10 showed reactivities with E7 protein in CaSki cell but not in HeLa by Western blot analysis. In addition, the Mab, VD6, reacted with COS-7 cell transfected with E7 gene majorly in cytoplasm by immunofluorescence test. Also VD6 could detect E7 protein in cytoplasm and nucleus of CaSki ceU by immunogold electron microscopy. Based on these results, the Mab VD6 was could be used for various E7 detection system such as Western blot analysis and immunohistochemical methods.
Animals ; Antibodies, Monoclonal* ; Bacteriophage T7 ; Blotting, Western ; Clone Cells ; COS Cells ; Cytoplasm ; Escherichia coli ; Fluorescent Antibody Technique ; Humans* ; Immunization ; Maltose-Binding Proteins ; Mice ; Microscopy, Electron

The plasminogen and plasmin system, which is mainly regulated by urokinase-type plasminogen activator (uPA), its receptor (uPAR) and its inhibitor (PAI-1), is generally believed to play a role in cancer invasion and metastasis. This study was conducted to investigate the role of uPA, uPAR and PAI-1 in the invasion and metastasis of gastric adenocarcinoma. The expression of mRNAs for uPA and PAI-1 was determined by Northern blot analysis in nine primary gastric cancer tissues, nine paired metastatic lymph nodes and normal gastric mucosa. The mRNA of uPA was not or faintly detected in normal mucosa, while the expression was increased in both primary gastric cancer tissues and metastatic lymph nodes to a similar degree. The mRNA expression for PAI-1 in the gastric cancer tissues was not different from that in the paired metastatic lymph nodes and normal mucosae. uPAR was determined by immunohistochemical staining, demonstrating that five (56%) and six (67%) out of nine primary gastric cancer tissues and nine paired metastatic lymph nodes were positive, respectively and the intensity was stronger in metastatic lymph nodes. The results support the concept that most gastric cancer cells may have an innately moderate level of uPA and uPAR, and that increase of uPAR expression can be considered to be closely associated with cancer invasion and metastasis.
Adenocarcinoma/*metabolism/pathology ; Gastric Mucosa/metabolism ; Gene Expression ; Human ; Immunoenzyme Techniques ; Lymph Nodes/metabolism/pathology ; Neoplasm Metastasis ; Plasminogen Activator Inhibitor 1/*biosynthesis/genetics ; Plasminogen Activators/*biosynthesis/genetics ; RNA, Messenger/biosynthesis ; Receptors, Cell Surface/*biosynthesis/genetics ; Stomach Neoplasms/*metabolism/pathology ; Support, Non-U.S. Gov't ; Urinary Plasminogen Activator/*biosynthesis/genetics

OBJECTIVE: The aim of this study is to evaluate the efficacy of additional three cycles of platinum- based chemotherapy in epithelial ovarian cancer patients with clinical complete response (CR). METHODS: Patients with histologically confirmed epithelial ovarian cancer stage II-IV and showing clinical CR after primary surgery and six cycles of chemotherapy with platinum-based chemotherapy entered into the study. Three cycles of platinum/paclitaxel (cisplatin/paclitaxel or carboplatin/paclitaxel) or cyclophosphamide/cisplatin, cyclophosphamide/adriamycin/cisplatin were administered as a consolidation chemotherapy only in patients with an agreement to informed consent. RESULTS: A total of 96 patients entered into the study. According to informed consent, 47 patients were treated by consolidation chemotherapy and 49 patients were followed up without further treatment. The median follow-up period was 30.5 months in total patients. The mean number of chemotherapy courses administered on the consolidation arm was 2.7. The median actuarial disease-free survival for the patients without consolidation chemotherapy arm was 26.0 months and consolidation arm, 27.0 months. No difference was detected in disease-free survival (p=0.89). Median overall survival is not reached, but there was no significant difference between the two arms of the trial (p=0.76). WHO grade 3-4 toxicity criteria were emesis (4.1% vs. 2.1%), anemia and/or neutropenia (10.2% vs. 19.1%), and others (4.1% vs. 21.3%). CONCLUSION: Although sample size is small and not randomized, these results suggest that platinum- based consolidation chemotherapy do not provide a favorable outcome in terms of disease-free survival in patients with a clinical CR after debulking surgery and six cycles of same regimen.
Anemia ; Arm ; Consolidation Chemotherapy ; Disease-Free Survival ; Drug Therapy* ; Follow-Up Studies ; Humans ; Informed Consent ; Neutropenia ; Ovarian Neoplasms* ; Pilot Projects* ; Sample Size ; Vomiting

OBJECTIVE: Lynch syndrome is a hereditary cancer syndrome that increases the risks of colorectal and gynecologic malignancies such as endometrial and ovarian cancer. Studies have shown that mutations in mismatch repair genes (MSH2, MSH6, and MLH1) are associated with Lynch syndrome. The aim of our study was to estimate the value of MSH2, MSH6, and MLH1 immunohistochemistry based on family history in a Korean sample. METHODS: Thirty six women with synchronous gynecologic tumors of endometrial and ovarian cancer were identified among patients being treated at our institution. Among them, 32 patients had tumor blocks (total 62 slides) available for analysis. According to a diagnostic algorithm, we performed immunohistochemistry analyses. Staining was scored based on intensity and proportion (negative or 0: intensity undetectable or minimal, proportion <5%; weak or 1+: intensity mild, proportion 5-30%; strong or 2+: intensity moderate to marked, proportion 30-99%). RESULTS: Among 32 eligible patients, 9 (28%) had a family history of cancer. Six patients (19%) were negative for MLH1; among them, four (4/6) were negative at both sites. Nine patients (28%) were negative for MSH2 or MSH6 at both sites or negative for both MSH2 and MSH6. Among these three patients showed negative staining for both sites. The three patients showing negative staining for MLH1, MSH2, and MSH6 at both sites with family history were considered to be the screening positive groups of Lynch syndrome. CONCLUSION: In this study, the frequency of Lynch syndrome associated immunohistochemical staining (MLH1, MSH2, and MSH6) group was estimated as 9% (3/32) among Korean women with synchronous gynecologic tumors.
Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair ; Female ; Humans ; Immunohistochemistry ; Mass Screening ; Negative Staining ; Neoplastic Syndromes, Hereditary ; Ovarian Neoplasms

OBJECTIVE: Hypoxia has been established as a key factor influencing the pathophysiology of malignant growth. Hypoxia-induced changes in gene expression are coordinated primarily by hypoxia inducible factor-1 alpha (HIF-1alpha) and HIF-2alpha. The purpose of this study was to determine whether or not HIF-2alpha expression is associated with survival and response to radiation in patients with cervical cancer. METHODS: After reviewing the medical records of 119 patients treated in our institution by primary therapy for stage IIB-IVA cervical cancer, we performed a case-control study. Cases (n=12) were selected from patients with local recurrence or radiation failure after primary radiation therapy with or without concurrent chemoradiation. For each case, we selected two controls from patients who had no evidence of local recurrence. Using pre-treatment paraffin-embedded tissues, we evaluated the expression of HIF-2alpha by immunohistochemistry. Staining was scored based on intensity (intensity score [IS], 0-3) and proportion (proportion score [PS], 0-100). The results were analyzed by the Student t-test, Mann-Whitney U test, Fisher's exact test, and Cox proportional hazards regression model. RESULTS: Cytoplasmic expression of HIF-2alpha, representing the degree of hypoxia, had a relationship with poor response to radiotherapy. The hazard ratio of recurrence was 1.71 for the HIF-2alpha IS (p=0.110) and 1.04 for the HIF-2alpha PS (p<0.001), indicating that the HIF-2alpha staining area correlates weakly with the risk for recurrence. CONCLUSION: The HIF-2alpha expression area may have an important role in radioresistance in patients with locally advanced cervical cancer. We conclude that a wider area of hypoxia predicts an increased probability of radioresistance.
Anoxia ; Case-Control Studies ; Cytoplasm ; Gene Expression ; Humans ; Immunohistochemistry ; Medical Records ; Recurrence ; Uterine Cervical Neoplasms